From eradication to resistance: five continuing concerns about pediculosis

Head Lice

Head lice infestation is associated with limited morbidity but causes a high level of anxiety among caregivers of school-aged children and adolescents. Since the 2015 clinical report on head lice was published by the American Academy of Pediatrics, new medications have been approved, and an algorithm for management of affected patients is included. This revised clinical report clarifies current diagnosis and treatment protocols.

Head lice

Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2010 clinical report on head lice was published by the American Academy of Pediatrics, newer medications have been approved for the treatment of head lice. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting.

Head lice

Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2002 clinical report on head lice was published by the American Academy of Pediatrics, patterns of resistance to products available over-the-counter and by prescription have changed, and additional mechanical means of removing head lice have been explored. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting.

Primary grade teachers' knowledge and perceptions of head lice

This study examined primary grade teachers' knowledge of head lice, perceived self-efficacy in dealing with head lice, and preferred resources of additional information on head lice. Survey data from a three-wave mailing (M = 292; 60%) found that teachers needed more knowledge regarding head lice and were significantly more knowledgeable as teaching experience increased. A plurality (46%) had high efficacy expectations scores regarding their ability to control the spread of head lice. Most (71%) primary teachers reported they received most of their head lice information from school nurses. Most (63%) said they would like more information on how to prevent head lice infestation, and they wanted the information in the form of videotapes (68%) and brochures (51%). Only 23% provided yearly instruction regarding head lice.

The challenge of choosing a pediculicide

Head lice is the most frequently occurring communicable disease, except for the common cold, among children in the United States. The impact on a family facing the challenge of head lice is tremendous, ranging from emotional to financial distress. Challenges also face the health care provider and school personnel. Many over-the-counter preparations and prescription products are available to combat head lice. With the alleged advent of pediculicide-resistant head lice, many other products and applications not necessarily intended to treat head lice are being recommended. The purpose of this article is to outline the products and procedures currently being utilized and to provide a starting point for treating head lice.

Head lice: is there a solution?

Head lice is an old problem that won't go away. Infestation with the head louse Pediculus capitis is still common in school-aged children. The majority of information about this condition is based on anecdotal evidence. There is a definite need for the standardization of detection methods for diagnosis and epidemiological purposes, and for properly designed trials to ascertain the effectiveness of the different treatment methods available.

School nurses' perceptions of and experiences with head lice

Researchers examined school nurses' perceptions of head lice, perceived self-efficacy in dealing with head lice, and personal experience in reducing head lice problems. Survey data from a two-wave mailing from 382 school nurses found most nurses supported a "no-nit" rule of forced absenteeism of any child with nits in their hair (60%). They perceived OTC treatments for head lice as very effective in killing adult lice (66%), and 9% perceived them as not effective. Nurses had a high efficacy expectation regarding their ability to control head lice (63%), and they had high outcome expectations regarding the results of their work with students and families of students (66%). Most nurses received their information about head lice from professional journals (76%) and professional conferences/conventions (62%).